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Organization
SSM HEALTH CARE ST. LOUIS
Active
Organization
SSM HEALTH CARE ST. LOUIS
Active
Other names
SSM Health St. Joseph Hospital - Lake Saint Louis Physician Billing
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN REWERTS (VP FINANCE)
(636) 625-5200
Entity
Organization
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-5200
(636) 625-5314
Mailing address
10176 CORPORATE SQUARE DR STE 100B, ATTNT: CREDENTIALING DEPT., SAINT LOUIS, MO 63132-2924
(314) 989-2615
(314) 810-1399
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NULL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
NULL
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
05/20/2006
Last updated
06/02/2026
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